| NPI | 1164643102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRA GOLDMAN Family Nurse Practitioner 502-641-0861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3295P) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2008-07-02 |